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The American Health Values Survey (AHVS) was conducted by the National Opinion Research Center (NORC) at the University of Chicago in order to develop a typology of Americans based on their health values and beliefs. The survey, of more than 10,000 adults from five individual communities, examined values and beliefs related to health at both the individual as well as societal levels. The community surveys sought to compare differences between the local typologies, but also to investigate any similarities with national typology groups. The survey assessed the importance of health in:

• day-to-day personal life (i.e. the amount of effort spent on disease prevention as well as appropriate seeking of medical care);
• equity, the value placed on the opportunity to succeed generally in life as well as on health equity;
• social solidarity, the importance of taking into account the needs of others as well as personal needs;
• health care disparities, views about how easy/hard it is for African Americans, Latinos and low-income Americans to get quality health care;
• and, the importance of the social determinants of health.

In addition, the survey also explored views about how active government should be in health; collective efficacy, the ease of affecting positive community change by working with others; and health-related civic engagement e.g. the support of health charities and organizations working on health issues.

There are public-use and restricted-use versions of the data provided for each of the five sentinel communities participating in this study. Although each site differs on the number of respondents as listed below, each data file contains the same 143 variables for each site and version of the data. The only difference between the public-use versus restricted-use versions of the data is the variable ZIP, which was MASKED in the public-use version.

• DS1 and DS2 - Baltimore, Maryland: 2,139
• DS3 and DS4 - Maricopa County, Arizona: 2,247
• DS5 and DS6 - Stockton, California: 2,127
• DS7 and DS8 - Mobile, Alabama: 1,821
• DS9 and DS10 - North Central counties in Nebraska: 2,846

The Robert Wood Johnson Foundation (RWJF) has a vision to build a Culture of Health (CoH) by making health a shared national priority, one valued and advanced by multiple stakeholders across all sectors of society. This vision embraces a very broadly integrated and comprehensive approach to health, one where well-being lies at the center of every aspect of American life. In 2014, the RWJF commissioned NORC at the University of Chicago to plan and conduct the first American Health Values Survey (AHVS) to understand the extent to which United States adults held views consistent with this vision. The idea was to explore which types of United States adults were more supportive and less supportive of the goal and what the differences were between the more and less supportive groups. To aid in the understanding of these differences, NORC developed a typology of United States adults based on their values and beliefs related to the CoH vision.

Using a large-scale national survey fielded in late 2015 and early 2016, NORC identified six major segments of the population of adults in the United States based on their differing health values and beliefs and developed detailed profiles of each segment that described their pattern of values and beliefs as well as their demographic, political and other characteristics. NORC subsequently replicated the typology development work in five RWJF Sentinel Communities across the nation and also developed a typology of rural America. The same segments, or similar ones, were common across various geographic areas of the United States. Four years have since passed, in which changes occurred in the country. RWJF in 2019 commissioned NORC to conduct a second national, cross-sectional survey (AHVS II) in late 2019 and early 2020.

The Forces of Change Survey is an annual survey completed by the state and territorial health agencies that comprise the membership of the Association of State and Territorial Health Officials (ASTHO). ASTHO is the national nonprofit organization representing public health agencies in the United States, the U.S. territories and freely associated states, and the District of Columbia, and the over 100,000 public health professionals these agencies employ. The Forces of Change Survey primarily focuses on emergent and rapidly changing trends. The data collected sought to determine the current climate at state and territorial health agencies as it related to budget, workforce, accreditation, and special interest topics. The 2017 Forces of Change Survey examined the following topics:

• Health agency resources
• Activities related to the Zika virus
• Opioid epidemic response
• Communicating the value of public health
• Efforts to advance health equity

The web-based survey, fielded by ASTHO in May of 2017, was administered to state and territorial health agencies through their senior deputies. A total of 52 health agencies responded (from 46 states, Washington, D.C., and five territories and freely associated states). Data included as part of this collection includes one dataset with 122 variables for 52 cases.

In the context of COVID-19, RAND and RWJF partnered again to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low to moderate-income backgrounds.

The questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents' views and priorities regarding health actions and investments are changing (including the roles of government and the private sector), and how general values about such issues as freedom and racism may be related to pandemic views and response expectations. The study is a longitudinal study, which collected data in four waves. The study also included 2 populations: A sample of populations at greater risk, and a general population sample. This study included the results for Wave 2 for populations at greater risk. The questions in the surveys were largely similar across all four waves.

Demographic info includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

In the context of COVID-19, RAND and the Robert Wood Johnson Foundation (RWJF) partnered again to build from the National Survey of Health Attitudes to implement a longitudinal survey to understand how health views and values have been affected by the experience of the pandemic, with particular focus on populations deemed vulnerable or underserved, including people of color and those from low to moderate-income backgrounds.

The questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents' views and priorities regarding health actions and investments are changing (including the roles of government and the private sector), and how general values about such issues as freedom and racism may be related to pandemic views and response expectations. Some questions used in the NSHA are fielded in this COVID-19 survey while others are newly used from other COVID-19 surveys or newly developed for this effort. The study is a longitudinal study, collecting data in four waves. The study also included 2 populations: A sample of populations at greater risk, and a general population sample. This study includes the results for Wave 4 for populations at greater risk. The questions in the surveys were largely similar across all four waves.

Demographic info includes sex, marital status, household size, race and ethnicity, family income, employment status, age, and census region.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

This study includes the results from the 2018 RWJF National Survey of Health Attitudes. This 2018 survey is considered the second wave, the first wave of the survey was conducted in 2015 (ICPSR 37405). In 2018, the study team fielded an updated version that included many of the same questions but added some new constructs that were of interest as part of the larger Culture of Health effort. This study complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016).

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes (NSHA) is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

This study includes the results from the 2023 RWJF National Survey of Health Attitudes. The 2023 survey is the third wave of the NSHA. The first wave was conducted in 2015 (ICPSR 37405) and the second wave in 2018 (ICPSR 37633). The 2023 report complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016), and its subsequent topline 2018 Survey of National Health Attitudes: Description and Top-Line Summary (Carman et al., 2019) and is organized similarly for consistency. A companion set of longitudinal surveys during the COVID-19 pandemic was fielded between 2020 and 2021 and is further described in four top-line reports, COVID-19 and the Experiences of Populations at Greater Risk (Carman et al., 2020-2021).

The questions in the 2023 survey uniquely capture aspects of American mindset about health, health equity, structural racism, and wellbeing in ways that are not present in other surveys. This version of the NSHA can be viewed in three main sections: (1) individual health experiences, perspectives, and knowledge (making health a shared value); (2) health equity perspectives; and (3) community wellbeing, including climate views and barriers to community engagement. Insights from the surveys referenced above, including this one, have established a baseline and set of cross-sectional pulse checks on where the American public is regarding their recognition of social determinants of health, their understanding of health inequities including structural racism, their willingness to address those inequities and their indication of who in society should be responsible for solving health inequities.